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Keeping the Joy in Medicine

The doctor-patient bond makes for healthier patients and satisfied caregivers.

By Dean/CEO Paul Rothman

Illustration credit: Sherrill Cooper

As you’ve read in this month’s special issue, all of us at Johns Hopkins Medicine believe that data science offers untold potential to improve human health.

As we apply the powerful tools of the new era, however, we also must grapple with complex questions about the art of doctoring in the age of computerization. Here at Johns Hopkins, we hosted a public forum on this topic in December with expert speakers, including Danielle Ofri, Kenneth Ludmerer and Abraham Verghese, who all have written at length about the place of humanism in current-day medicine.

A highly attuned physician-patient partnership is the bedrock of effective care. As we move forward, we must ensure that technology complements, not undermines, that bond, and that we continue to respect not only the humanity of the individual patient, but also the humanity and skill of the practitioner. It is not just about doing what’s best for our patients. It’s also about preserving the joy in medicine for our physician workforce.

We recently polled employees across Johns Hopkins Medicine on this question: “What brings you joy at work?” Some faculty and staff members said they take satisfaction from mentoring others and watching them grow. Others find joy in their friendships with colleagues or in making original contributions to science.

Among our physicians, the responses were fairly uniform. Nearly all said they get fulfillment from getting to know patients, partnering with them on a care plan and then watching their health improve. However, certain aspects of today’s practice environment can compromise the quality and depth of these relationships, making joy a bit more elusive.

In September, I participated in a daylong consortium, sponsored by the American Medical Association, on the topic of physician well-being and its impact on health care. We had a series of lively conversations about enhancing joy in the practice of medicine and heard a presentation from Mayo Clinic’s Tait Shanafelt. He worries we are at a tipping point as a profession, with more than half of physicians reporting symptoms of burnout.

Our faculty and staff at Johns Hopkins Medicine are under the same pressures as others around the country. Beyond the heightened demands from new technologies, such as electronic health records and the ever-growing need for documentation, they are contending with fluctuating research budgets, changes in reimbursement, new regulations and other external forces that take away from face time with patients.

In the midst of all this change, we have to be intentional about cultivating joy in medicine. We must communicate with our clinicians about what support systems would be most valuable so that we can maximize their engagement and help them achieve their professional goals. The role of the institution is to supply the scaffolding to ensure that the practice environment is efficient, the culture is nurturing, relationships are protected and, most importantly, that all can continue to find meaning in their work.

To that end, we are forming a new Joy in Medicine Task Force for Johns Hopkins Medicine. Led by our vice deans for clinical affairs and faculty affairs, this group will have broad, multidisciplinary representation from across our medical school and health system. The committee will survey our employees to assess their needs, review the literature, talk to peer institutions and put forth a blueprint for boosting satisfaction.

To be clear, “joy in medicine” does not apply only to physicians. We are looking at ways to better engage nurses, trainees, hospital staff members and all the many players involved in the provision of health care.

Medicine is a demanding profession. The training is grueling, the hours are long and the stakes are high. Fortunately, the rewards—which derive first and foremost from the healing relationship with the patient—more than offset the challenges. As we redesign our health care systems for the future, we must couple the tools of the new millennium with the time-honored human touch and the compassion that defines our profession.